Introduction to Behaviour

UNIT 1 INTRODUCTION TO BEHAVIOUR Modification and Cognitive

Approach in Counseling
MODIFICATION AND COGNITIVE
APPROACH IN COUNSELING
Structure
1.0 Introduction
1.1 Objectives
1.2 Introduction to Behaviour Modification
1.2.1 Definition of Behaviour
1.2.2 Meaning of Behaviour Modification
1.2.3 Principles of Behaviour Modification
1.2.4 Steps/ Procedure in Behaviour Modification
1.2.5 Techniques of Behaviour Modification
1.2.6 Potentials and Limitations of Behaviour Modification
1.3 Introduction to Cognitive Approach
1.3.1 Steps/Procedure in the Cognitive Therapy
1.3.2 Techniques of Cognitive Therapy
1.3.3 Cognitive Behaviour Therapy
1.3.4 Techniques Used by CBT Specialists
1.4 Rational Emotive Behaviour Therapy
1.4.1 The Sequences in REBT Model
1.4.2 Potentials and Limitations of Cognitive Behavioural Approach
1.5 Let Us Sum Up
1.6 Unit End Questions
1.7 Suggested Readings

1.0 INTRODUCTION
Learning is an integral part of life. We learn and unlearn many things from our day to
day experience. Since we learn things, we can also unlearn those things. The
behavioural counseling approach is based on this assumption of learning and unlearning
different aspects of behaviour. We tend to acquire and continue those behaviours
that are approved, reinforced and rewarded; whereas behaviour that is not approved
or considered undesirable tend to disappear. Thus the behavioural approach makes
use of principles of reward, reinforcement and punishment to bring about desired
changes in behaviour. However, this approach was mechanical in nature which
assumed that human behaviour is governed by external stimuli only.
Human being is not so mechanical as to be regulated by the S – R (stimulus-response)
mechanism. What about the thoughts, perception, feelings and beliefs of the human
being? Hence it is not only the mechanical acquisition of physical responses, but the
perception of the situation by the child also gets associated with physical responses.
This led to the emergence of cognitive behavioural approach ( Ellis, 1962; Beck,
1976; Meichenbaum,1977). According to this approach, thoughts, ideas, beliefs
form an important part of behaviour which is learned. The behavioural view ignored 5
Cognitive Behavioural the subjective experiences of the individual. The individual was seen as passive
Counseling
human beings having no free will of their own. However, the cognitive behavioural
approach considered thoughts, ideas, beliefs as important part of human behaviour.
Thus in this unit we are going to learn about the meaning of behaviour approach as
well as cognitive approach to counseling. The procedure for each approach will be
described and the different techniques under behavioural modification and cognitive
approach will also be discussed. Finally the potentials and limitations of both
behavioural and cognitive approaches to counseling will be delineated.

1.1 OBJECTIVES
After completing this unit, you will be able to:
● Define behaviour modification and cognitive approach in counseling;
● Explain the principles of behaviour modification;
● Describe the procedure of behaviour modification and cognitive therapy;
● Explain the different techniques of behaviour modification and cognitive therapy;
and
● Analyse the potentials and limitations of both behaviour and cognitive therapy.

1.2 INTRODUCTION TO BEHAVIOUR

MODIFICATION
Behaviour modification or behavioural counseling is a form of psychotherapy that is
based on the learning theories of classical conditioning and operant conditioning. It
applies these learning principles to bring about positive changes in behaviour and
reduce or eliminate undesirable behaviour. Behaviour modification employs
empirically tested behaviour change techniques to improve behaviour and/or reduce
maladaptive/undesirable behaviour. It refers mainly to techniques for increasing
adaptive behaviour through reinforcement and decreasing maladaptive behaviour
through extinction or punishment.
The first use of the term behaviour modification appears to have been used by
Thorndike in the year 1911. He talked about the Law of Effect where responses
followed by satisfying state of affairs were strengthened whereas responses followed
by dissatisfying state of affairs were decreased or discontinued. The learning theories
of classical conditioning by Pavlov and operant conditioning by Skinner have further
contributed to the development of behaviour modification approach to counseling.
Classical conditioning proposes that our behaviour /responses are conditioned, i.e.,
there is an association between the stimulus which elicits the response and our
response. When this association becomes strengthened on the basis of reward,
conditioning happens and the behaviour is learned. This is the basic conditioning
process. Operant conditioning is based on the law of effect. This conditioning consists
of behaviour that is followed by consequences that are satisfying to the organism
and so will be repeated. Behaviour that is followed by unpleasant consequences will
be discouraged. For example, when a child throws temper tantrum, parents give in
to his demand. As a result, the child learns that if he throws tantrums, his needs will
be satisfied. Here parents attention and giving in to his demand is the reinforcer for
the child and thus the child will repeat the same behaviour in the future.

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1.2.1 Definition of Behaviour Introduction to Behaviour
Modification and Cognitive
Approach in Counseling
First let us see what do we mean by behaviour? Behaviour is such a term which we
use commonly and yet we may not be aware of its exact meaning. We talk about
behaviour using the terms such as hard-working, kind, sociable, ungrateful,
independent, selfish etc. However, if we analyse, these terms do not refer to the
specific things we note in a person when for instance, we say hard-working or
selfish. In general we may understand what selfish behaviour means or nervous
behaviour means; but we may not know the person’s nervousness refers to his nail-
biting, or fidgeting, or pacing in the room? It is very essential that we talk about
behaviour very specifically.
Essentially, behaviour is anything that a person says or does. Behaviour modifiers
generally talk very precisely about the behaviour. This helps in focusing on the
particular aspect of behaviour which need to be changed. Behaviour also need to be
described either as behavioural deficits or behavioural excesses. Behavioural deficit
refers to something lacking, e.g., the child is not able to mix and interact with his
classmates; the child has not learned how to eat in a proper manner in a restaurant;
the teacher is not able to manage her anger if some child disturbs her class; the
manager does not know how to conduct himself in a board meeting. Behavioural
excesses refer to behaviour which is out of control, for example, a child showing
tantrums; an adult engaged in continuous smoking or drinking; a child eating candies
and toffees frequently; or seeing television continuously.
Thus there is a deviation of behaviour, either lack or excess of behaviour, which
causes the problem and need to be addressed. Behaviour modification helps in
changing these problem behaviours and establishing the appropriate behaviour.
However, one thing to be noted here is that identification of behavioural lack or
behavioural excess should always consider the context, the culture and the ethics of
the persons involved. Although some behaviour like self injurious behaviour is always
inappropriate no matter what the context is.

1.2.2 Meaning of Behaviour Modification

Thus Behaviour modification can be described as an approach to psychotherapy
which is based on learning theory and aims to address the client’s problems through
techniques designed to reinforce desired and eliminate undesired behaviours. The
behaviour modification approach involves the development and encouragement of
desirable behaviours and removal and reduction of undesirable behaviours by
methods based on the learning and reinforcement principles.
In simple terms, behaviour modification assumes that behaviours can be acquired/
learned and can also be unlearned. Hence if the child has learned any negative
behaviour, it can also be unlearend and new desirable behaviour can be learned.
Thus the relationship between observable stimuli and response is important; and
reward and punishmnet can be used to control and regulate this relationship between
stimulus and response.
Thus according to Skinner, greater or lesser reinforcement can be used to modify
behaviour. For example, Rajan , a 5 year old boy always pushes other children in
front of him and has not learned to stand in a line and wait for his turn. Behaviour
modification in this case will help the child to change his behaviour by the use of
reward and learn to be disciplined while standing in a line.
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Cognitive Behavioural 1.2.3 Principles of Behaviour Modification
Counseling
Behaviour modification principles and practices are used to assist individuals with
developing new, desirable behaviours while eliminating behaviours that are no longer
useful. Reinforcement and punishment are the main principles of behaviour
modification. Reinforcement strengthens a behaviour, while punishment weakens a
behaviour. Both can be either positive or negative.
Positive reinforcement describes desirable behaviour rewarded with a pleasant
stimulus, while negative reinforcement describes desirable behaviour rewarded with
the removal of a negative stimulus.
Positive punishment occurs when an undesirable behaviour results in the addition of
a negative stimulus, while negative punishment occurs when an undesirable behaviour
results in the removal of a pleasant stimulus. For example, a rat accustomed to
receiving food when pressing the lever, no longer receives food when pressing the
lever. The rat has experienced negative punishment. However, positive punishment
is not much used, because when misused, more aversive punishment can lead to
affective/emotional disorders. The difference between positive and negative
reinforcement is that in positive reinforcement, a response/behaviour produces a
stimulus (positive reinforcer), whereas in negative reinforcement a response removes
the occurrence of a negative stimulus. Examples of positive reinforcers are food,
money, recognition; whereas negative reinforcement leads to the learning of avoidance
and escape responses. For instance, when we ignore the child when he throws a
tantrum, it is a negative reinforcement.
Thus positive reinforcement as well as negative reinforcement both tend to increase
or strengthen behaviour. However, negative punishment , decrease or weaken the
undesirable behaviour. When the child misbehaves and given time out ( removal of
the pleasant stimulus, for example, being with friends), it leads to decrease the
undesirable behaviour of the child.
The principles of operant conditioning which are used for the behaviour modification
also applies a schedule of reinforcement to bring about the desired results. Target
behaviours are reinforced as soon as they occur, while negative behaviours are
discouraged. Reward and punishment tools are also used to strengthen new
behaviours. In effect, these tools work to redirect a person’s motivations toward the
desired outcome.
Further, a behaviour, or habit, is framed by what happens before and what happens
after the behaviour is carried out. The principle of extinction is also made use of
which works by removing or changing what happens after the behaviour takes place.
In effect, the incentive or reward that motivates a person to carry out a certain
behaviour is taken away. When this happens over and over again, the motivation to
indulge in a certain behaviour begins to fade. Eventually the behaviour itself becomes
extinct for lack of incentive.

Self Assessment Questions

1) Explain the meaning of ‘behaviour’.
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 Introduction to Behaviour
2) What do you understand by the term behaviour modification? Modification and Cognitive
Approach in Counseling
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3) Describe the principles of behaviour modification.
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4) Fill in the blanks with the following alternatives:
(Deficits, reinforcement, undesirable, unlearned)
a) Behaviour modification involves the reduction of ________ behaviours.
b) Behaviour modification makes use of the principle of ________to bring
desirable changes in behaviour.
c) The basic premise of behaviour modification is that ‘if a behaviour is
learned, it can be _________.’
d) Behaviour is described in terms of behavioural excesses and behavioural
_________.

1.2.4 Steps/Procedure of Behaviour Modification

The goal of behaviour modification is always to bring about a change in the behaviour.
The change may be in terms of:
● a newly developed behaviour
● increase or strengthening of a behaviour
● maintaining a behaviour at a particular rate or pattern of occurrence
● decrease or change in a behaviour
Deciding the goal is only one part of the entire procedure for behaviour modification.
First of all we need to analyse the problem behaviour through a process of behavioural
assessment. Behavioural assessment helps us to understand the problem in its different
aspects, in different contexts and across different settings/situations. The problem is
studied in detail:
Frequency – how often the behaviour occurs, e.g., how many times the child has
used abusive language in a class duration
Duration – how long the problem behaviour lasts, e.g., the child goes on talking
abusive language or uses it for a while only
Intensity – how severe is the behaviour, e.g., the child uses extreme abusive language
or mild abusive language
Thus baseline data forms an important step in the behaviour modification plan. Specific
information about the behaviour is collected . The ABC model of behavioural
analysis, also called functional analysis is used. The ABC model refers to 9
Cognitive Behavioural ● A antecedent it: describes what happens just before the occurrence of the
Counseling
behaviour
● B behaviour: it describes the client’s behaviour
● C consequence: it describes the consequence, i.e. what happens after the
behaviour
Antecedents help in understanding the problem in detail, what precipitates the problem,
when it occurs, at what setting it occurs, who are present, what type of event/
situation usually leads to the behaviour/ problem in question. Behaviour refers to the
behaviour shown or demonstrated. Consequences determine the client’s behaviour.
Consequences refer to what does the behaviour lead to- how do parents, teachers,
peer respond to the child’s behaviour – this determines whether the behaviour will
continue or be modified or decrease or increase.
In other words, the ABC model can be described as follows: What comes directly
before the behaviour?”, “What does the behaviour look like?”, and “What comes
directly after the behaviour?” respectively. Once enough observations are made, the
data are analysed and patterns are identified. If there are consistent antecedents
and/or consequences, an intervention should target those to increase or decrease
the target behaviour. If the behaviour pattern shows a particular antecedent or trigger,
then intervention can be to avoid that trigger as far as possible and to learn a new
behaviour in the presence of the trigger. If a problem behaviour occurs because it
achieves some purpose, then there is a requirement to teach an alternative behaviour
which will achieve the same purpose without creating any problem.
The functional assessment helps in understanding the behaviour . This facilitates in
planning the appropriate intervention technique. The following steps can be delineated
in the behavioural assessment process:
The problem behaviour is described in detail with example of its occurrence.
● All the antecedent factors are also elaborated.
● The consequences are noted down.
● The goals are specified.
● Accordingly the target response is stated in precise terms.
● The particular intervention to be used is finalised and implemented.
● Follow up and evaluation is done. If the intervention did not bring in the desired
result, then we again go back to the first step of analysing the problem in detail
in terms of the antecedent factors and then deciding on the intervention strategies
to be adopted.
For instance, the problem is the aggressive behaviour of the child in the playground.
Examples of occurrence of the aggressive behaviour by the child in the playground
is cited. When did it occur, how did it start, what was the duration and intensity etc.
The consequences: how did the teacher react to the aggressive behaviour of the
child, how did other classmates present reacted , and any other consequence, may
be punishment by the principal of the school are also noted. Analysis of the antecedent
and consequences of the problem then leads to the setting of goals. The goal may be
to reduce the aggressive behaviour of the child. To achieve this goal, the target
response, i.e. the response which need to be changed are specified. In this case, the
target responses may be reduction in hitting behaviour, using abusive language,
overcoming getting angry very quick. Thereafter, the appropriate intervention
technique to be used are decided and implemented.
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1.2.5 Techniques of Behaviour Modification Introduction to Behaviour
Modification and Cognitive
Approach in Counseling
Behaviour modification uses different techniques to modify a person’s behaviour.
It’s based on the use of a reward system that targets specific behaviours. Rewards
are used to reshape a person’s motivations so old habits are eliminated and new,
more beneficial habits are formed.
Three techniques of behaviour modification are (i) systematic desensitisation, (ii)
aversive conditioning and (iii) token economy. Other techniques include (iv) extinction
and (v) biofeedback. The three techniques are given in detail in the following
paragraphs.

i) Systematic Desensitisation
Systematic desensitisation is a behaviour modification practice used to eliminate
fears or undesirable emotions. It is based on the classical conditioning principles of
pairing anxiety provoking stimulus/event with a relaxation response. Exposure to
the fear-producing stimuli while focusing on relaxation techniques eventually leads
to the fear-inducing stimuli resulting in the relaxation response, rather than fear. The
assumption here is that relaxation and anxiety cannot go together. If we bring in
relaxation, then anxiety has to go. Thus systematic desensitisation uses the principle
of counter conditioning, which counters the anxiety connected with a particular
behaviour or situation by inducing a relaxed response to it instead. This method is
often used in the treatment of people who are afraid of flying. Another example of
this practice will be removing the fear of public speaking. This is done by gradually
exposing the person to the experience of public speaking. Speaking in front of the
family or a small group of friends may be the first step. The person then gradually
works up to speaking in front of a larger group of strangers or associates.
Systematic desensitisation involves the following steps:

Step 1: Constructing an anxiety hierarchy

The first and most important requirement is to construct/prepare a list of all the
situation/events/objects that evoke fear or anxiety in the client. This has to be arranged
in a hierarchical order from lowest anxiety provoking stimulus to the highest anxiety
provoking stimulus. The degree to which each item produces anxiety is measured in
terms of Subjective Unit of Distress (SUD).There should usually be 5-10 SUD
difference between each item in the hierarchy. An example of an anxiety hierarchy in
case of a person who has fear of speaking in the public is as follows. Rahul is a
newly recruited manager of the company and he has to attend a conference of the
managers from the region and represent his company’s policies and progresses. But
Rahul is very anxious about this . Systematic desensitisation can be used to help
Rahul overcome his anxiety. First of all the counselor can help Rahul construct an
anxiety hierarchy. The list may be as follows:
Two weeks before the conference, reading the brochure for the conference of the
managers
Ten days before the conference, discussing with senior managers about things to be
presented in the conference.
Eight days before the conference, discussing with the colleagues about the conference.
Six days before the conference, preparing notes on the things to be presented.
Four days before the conference, rehearsing the things to be presented
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Cognitive Behavioural One day before the conference, keeping the materials ready that need to be taken
Counseling
to the conference.
The night before the conference day
Morning of the conference, getting ready for the conference
Arriving at the conference venue
Meeting other managers from other companies
Rahul’s turn comes to present his company’s case

Step 2: Training in relaxation

This consists of helping the client achieve a relaxed state of body and mind. Different
kinds of relaxation techniques are available. Jacobson’s progressive muscular
relaxation is commonly used, though it requires training and takes longer time. Among
other relaxation methods are ‘Shavasana’, meditation, ‘pranayama’ and so on. The
main thing here is that the client should find it comfortable and achieve the desired
state, i.e., relaxation. Jacobson’s relaxation technique is based on the premise that
muscular tension and relaxation are incompatible. It involves creating muscular tension
in each part of the body and then relaxing it. This practice of alternatively tensing and
the relaxing the group of muscles one by one creates a very relaxed state, e.g., for
relaxing hands, make a fist , create the tension , feel it, and the gradually relax them
by releasing the hand. When we are in anxious state our muscle groups ate tensed.
Hence we need to know how to release that tension and make it relaxed.
Step 3: Presenting anxiety provoking items during relaxation state
The last step is presenting the hierarchy of anxiety provoking items one by one when
the client is in a relaxed state. It starts from the lowest anxiety producing stimulus to
the highest anxiety producing stimulus. The client relaxes and then presented with
the first item in the list, and the the client relaxes again. Then the client is presented
the next item in the list. The client visualizes each stimulus/situation for at leas 20-30
seconds. If the client experiences anxiety while visualizing any particular item, he can
stop there and relax; and then visualize a new item in between, e.g., in the above
instance, if Rahul experiences anxiety at the item – six days before the conference;
then a new item can be introduced there – seven days before the conference.
This pairing of anxiety provoking situation with relaxation helps one to be able to
face the situation and gradually gain confidence in approaching the real life situation
later.

ii) Aversive Conditioning

Aversion helps break bad habits through associating aversive stimuli to the undesirable
habit. Eventually, the undesirable habit becomes associated with the negative
consequence and the behaviour is reduced.. This technique employs the principles
of classical conditioning to lessen the appeal of a behaviour that is difficult to change
because it is either very habitual or temporarily rewarding. The client is exposed to
an unpleasant stimulus while engaged in or thinking about the behaviour in question.
Eventually the behaviour itself becomes associated with unpleasant rather than pleasant
feelings. One treatment method used with alcoholics is the administration of a nausea-
inducing drug together with an alcoholic beverage to produce an aversion to the
taste and smell of alcohol by having it become associated with nausea.

12
iii) Token Economy Introduction to Behaviour
Modification and Cognitive
Human behaviour is routinely motivated and rewarded by positive reinforcement. Approach in Counseling
Token economy is based on systematic positive reinforcement where rules are
established that specify particular behaviours that are to be reinforced, and a reward
system is set up. A token economy is a highly effective behaviour modification
technique, especially with children. In this technique, desired behaviours result in the
reward of a token—such as a poker chip or a sticker—and undesirable behaviours
result in the removal of a token. When children obtain a certain number of tokens,
the children get a meaningful object or privilege in exchange for the tokens. Eventually,
the rewarding of tokens decreases and desirable behaviours display independently.

iv) Extinction
Eradicating undesirable behaviour by deliberately withholding reinforcement is another
popular treatment method called extinction. For example, a child who habitually
shouts to attract attention may be ignored unless he or she speaks in a conversational
tone. This is based on the principle that if the behaviour is not rewarded or encouraged,
it will become extinct.

v) Biofeedback
Behaviour modification principles also can be used to treat emotional problems that
are triggered by a physical symptom. Biofeedback is a method that provides immediate
feedback on a person’s physiological state, be it heart rate, breathing rate or blood
pressure. Feedback is provided by a mechanical device that lets the person know
when a particular symptom is present. By controlling the symptom, the resulting
emotional response can be prevented. An example of this would be someone who
has problems controlling anger. The increases in breathing rate and heart rate can be
monitored and controlled with practice. Once controlled, a person is better able to
control an angry outburst.

1.2.6 Potentials and Limitations of Behaviour Modification

The whole point of behaviour modification techniques is to change undesirable or
harmful behaviours and replace them with healthier, more desirable ones. There are
many advantages of the behavioural approach to counseling.
When applied properly, the technique can be effective in working with children,
adults and animals also. In fact it can be used for changing the behaviour of any living
beings. Animal trainers frequently turn to behaviour modification techniques to help
pet owners turn bad habits into good habits. They also make use of behaviour
techniques to train animals the different types of new behaviour as we see in animal
and birds shows.
Behavioural modification aims at enabling the clients to take charge of their behaviour.
Substance abuse counselors, for example, often encourage clients to take ownership
of their behaviours and change them using behaviour modification techniques. The
subject/client in the behavioural intervention takes an active role and ownership of
the change process.
The basic concepts and methods of behaviour modification are pretty easy to
understand and implement.
Behavioural approach focusses on the current behavioural problems in the context
of the individual’s current environment/situation. It does not analyse the past events/
happenings/situation. 13
Cognitive Behavioural Behavioural intervention spells out achievable behavioural goals in terms that enable
Counseling
you to measure your success. The intervention techniques follow a systemaic step
by step procedure. A series of steps are delineated that to bring about change and
lead to the desired behaviour.
There are a variety of therapeutic techniques and procedures associated with
behaviour modification, so the technique is best used by specially trained, skilled
practitioners.

Self Assessment Questions

1) Describe the process of functional analysis of behaviour with example.
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2) Seema has extreme fear for examination. Construct an anxiety hierarchy for
her.
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3) Explain the meaning of token economy.
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4) List out the advantages of behavioural approach in counseling.
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5) Fill in the blanks from the following choices:
(Consequence, frequency, present, antecedent)
a) ______ refers to the number of times a behaviour occurs.
b) __________ describes the things that occur before the occurrence of
the problem behaviour.
c) In the ABC model of behaviour analysis, C refers to ____________.
d) Behavioural approach in counseling focuses on the ________ events.

14
 Introduction to Behaviour
1.3 INTRODUCTION TO COGNITIVE APPROACH Modification and Cognitive
Approach in Counseling
Cognitive approach in counseling emphasises the role of cognition or thought in
influencing our behaviour. As opposed to behavioural changes based on reward or
punishment system, the cognitive approach focuses on the role that thinking plays in
how do we feel and behave. Transformation of how one thinks becomes critical in
producing behavioural changes. Cognitive approach in counseling points out the
dynamics of the human being in terms of his thoughts, attitudes, beliefs and values.
Hence it is not simply a stimulus – response mechanism; the organism in between
plays a vital role with all his thoughts and attitude in bringing about behavioural
changes.
The fundamental principle here is that thoughts (cognitions) cause our feelings and
behaviours. Thus cognitive therapy is based on the idea that our thoughts cause our
feelings and behaviours, not external things, like people, situations, and events.
Hence we can change the way we think to feel / act better even if the situation does
not change. Thus, in cognitive therapies the counselors focus on teaching the clients
how to think differently. Therefore, the goal of therapy is to help clients unlearn
their unwanted reactions and to learn a new way of reacting. Therapists in the
cognitive field work with clients to solve present day problems by helping them to
identify distorted thinking that causes emotional discomfort. There’s little emphasis
on the historical root of a problem. Rather, the focus is on what’s wrong with my
present thinking that is causing me distress.
Aaron Beck developed cognitive therapy in the 1960s. The treatment is based on
the principle that maladaptive behaviour (ineffective, self-defeating behaviour) is
triggered by inappropriate or irrational thinking patterns, called automatic thoughts.
Instead of reacting to the reality of a situation, an individual automatically reacts to
his or her own distorted view of the situation. Cognitive therapy strives to change
these thought patterns (also known as cognitive distortions), by examining the
rationality and validity of the assumptions behind them. This process is termed
cognitive restructuring.
Cognitive therapy is different from behaviour therapy in that it focuses mostly on the
thoughts and emotions that lead to certain behaviours.
In other words, behaviour therapy is more action-based and cognitive therapy is the
mental or emotional beginnings that drive us to perform those actions. Usually in
practice both cognitive and behavioural principles are combined to deal with the
problems. Hence it is called cognitive behavioural approach which counselors more
frequently use in counseling. Most therapists seem to feel that the best form of
psychotherapy is a combination of these two principles. This is what’s known as
cognitive behaviour modification, or cognitive-behavioural therapy,
Cognitive behavioural therapy is based on the idea that our feelings are governed by
our thoughts about situations, people, and events in our lives and not those things
themselves. Rather than focusing on changing the external forces we see as causing
the problems, cognitive behavioural therapy focuses on changing the way we think
to help us feel better. By learning to think differently, a person can develop rational
self-counseling skills that can be used to deal with life. Thus cognitive behaviour
therapy is defined as therapy that is based on the belief that our thoughts are directly
connected to how we feel. Cognitive-behavioural therapy attempts to change clients’
unhealthy behaviour through cognitive restructuring (examining assumptions behind
the thought patterns) and through the use of behaviour therapy techniques. For 15
Cognitive Behavioural instance, in the treatment of eating disorders, therapists can help clients to change
Counseling
attitudes and thoughts about ideal body shape and weight; but also at the same time
should focus on changing the client’s behaviour of eating unhealthy diet and replace
it with normalised eating patterns. Thus both cognitive as well as behaviour therapy
are involved.

1.3.1 Steps/Procedure of Cognitive Therapy

The focus in cognitive behaviour intervention is the thinking pattern. Hence the first
important step is to identify the faulty/irrational thought patterns. Using the Socratic
method is one way to do this. By questioning our thoughts about a situation that
creates anxiety and stress in us, we can pinpoint the irrational assumptions through
which we view situations. If a person is upset because a friend isn’t returning a
phone call, he may assume that the friend is angry with him; whereas it may be that
his friend might have been busy in some important work. Similarly, when the officer
calls his junior repeatedly and the latter does not pick up the phone, the officer
thinks that the junior knowingly avoids to do work. However, it may be that the
junior could not answer the call because of some problem in the phone. Once a
person understands their irrational thought patterns, they can use this information to
modify their behaviour as they deal with the situations and events of their life that
might be causing them problems
In many instances we jump to immediate conclusion and our behaviour becomes
governed by this. However, this may lead to problem behaviour. Immediate emotional
reactions to situations are created in an area of the brain known as the limbic system.
This area of the brain moves fast and reacts to situations based on instantly made
impressions. This is helpful when a speeding car is coming at us and we need to
freak out and run, but more complex situations need a reaction based more on
knowledge, facts, and experience. In these situations speed is not a virtue. The part
of the brain used to process these facts is the prefrontal cortex. Unfortunately, this
area of the brain takes longer to react, giving people the opportunity to act impulsively
in situations using irrational assumptions. If a person can learn to modify the impulsive
behaviour and wait for the prefrontal cortex to kick in (in other words, think things
through), they can modify the effect the situation has on their emotional state and,
sometimes, the situation itself in a more positive manner. Thus irrational ideas/thoughts
need to be identified and questioned in order for the positive change in behaviour to
occur.
Corey (2009) proposes the following three stages in cognitive behaviour therapy.

Phase 1: Self-Observation
This phase involves listening closely to your internal dialogue or self-talk and observing
your own behaviours. You want to be especially aware of any negative self-statements
that are actually contributing to your anxiety and panic symptoms.

Phase 2: Begin New Self-Talk

Once you recognise your negative self-talk, you can begin to change it. As you
“catch” yourself in familiar negative thought patterns, you recreate a new and positive
internal dialogue. “I can’t” becomes “It may be difficult, but I can.” These new self-
statements now guide new behaviours. Rather than using avoidant behaviours to
cope with panic and anxiety, you become willing to experience the anxiety-provoking
situations. This leads to better coping skills, and as your small successes build upon
16 one another, you make great gains in your recovery.
Phase 3: Learning New Skills Introduction to Behaviour
Modification and Cognitive
Each time you are able to identify and restructure your negative thoughts and change Approach in Counseling
your response to panic and anxiety, you are learning new skills. Because you are
now acutely aware of your thoughts, you are better able to gauge your anxiety and
react in a more useful manner.
When your negative thoughts control you, it becomes difficult to control your
behavioural responses to unpleasant situations. But, CBM can give you back some
lost control. As your thoughts change from negative to positive, you start to behave
differently in many situations. And, you will likely find that others react differently to
the new “positive” you as well.

Self Assessment Questions

1) Discuss the meaning of cognitive therapy.
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2) Describe the stages in cognitive therapy.
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3) Fill in the blanks from the following alternatives.
(Restructuring, thoughts, distortions)
a) Cognitive therapy places emphasis on _________.
b) Cognitive therapy achieves its aim through cognitive ___________.
c) The irrational thought patterns are also called cognitive __________.

1.3.2 Techniques of Cognitive Therapy

The prominent cognitive therapies are Cognitive Behaviour Therapy by Aaron Beck
(1976) and Rational Emotive Behaviour Therapy by Albert Ellis (1960). Eric Berne’s
(1964) Transactional Analysis is also another cognitive intervention used by the
therapists.

1.3.3 Cognitive Behaviour Therapy

The therapy assumes that an individual’s emotions and behaviour are the outcome
of the way in which he thinks about the world. According to Beck, people experience
emotional problems when they engage excessively in fallacious or dysfunctional
thinking. These are irrational or faulty thought patterns. Here are the ten most common
irrational thought patterns or cognitive distortions (Beck, 1976; Burns, 1992).

17
Cognitive Behavioural All or none thinking
Counseling
This is thinking in terms of either good or bad, e.g., your friend always needs to be
good to you.
This type of distortion is the culprit when people think in extremes, with no gray
areas or middle ground. All-or-none thinkers often use words like “always” and
“never” when describing things. “I always get stuck in traffic!” “My bosses never
listen to me!” This type of thinking can magnify the stressors in your life, making
them seem like bigger problems than they may, in reality, be.

Overgeneralisation
It refers to our drawing a conclusion based only on a single incident, e.g., when you
asked for some help to your neighbour and did not get it, you conclude that your
neighbour is not good. Those prone to overgeneralisation tend to take isolated events
and assume that all future events will be the same. For example, an overgeneraliser
who faces a rude sales clerk may start believing that all sales clerks are rude and that
shopping will always be a stressful experience.

Mental Filter
Those who use mental filtering as their distortion of choice tend to gloss over positive
events and hold a magnifying glass to the negative. Ten things can go right, but a
person operating under the influence of a mental filter may only notice the one thing
that goes wrong. (Add a little overgeneralisation and all-or-nothing thinking to the
equation, and you have a recipe for stress.)

Disqualifying the Positive

Similar to mental filtering, those who disqualify the positive tend to treat positive
events like flukes, thereby clinging to a more negative world view and set of low
expectations for the future. Have you ever tried to help a friend solve a problem,
only to have every solution you pose shot down with a “Yeah but...” response?
You’ve witnessed this cognitive distortion firsthand.

Jumping to Conclusions
People do this one all the time. Rather than letting the evidence bring them to a
logical conclusion, they set their sights on a conclusion (often negative), and then
look for evidence to back it up, ignoring evidence to the contrary. The kid who
decides that everyone in his new class will hate him, and ‘knows’ that they’re only
acting nice to him in order to avoid punishment, is jumping to conclusions. Conclusion-
jumpers can often fall prey to mind reading (where they believe that they know the
true intentions of others without talking to them) and fortune telling (predicting how
things will turn out in the future and believing these predictions to be true).

Magnification and Minimization

Similar to mental filtering and disqualifying the positive, this cognitive distortion
involves placing a stronger emphasis on negative events and downplaying the positive
ones. The customer service representative who only notices the complaints of
customers and fails to notice positive interactions is a victim of magnification and
minimization. Another form of this distortion is known as ‘catastrophizing’, where
one imagines and then expects the worst possible scenario. It can lead to a lot of
stress.
18
Emotional Reasoning Introduction to Behaviour
Modification and Cognitive
This one is a close relative of jumping to conclusions in that it involves ignoring Approach in Counseling
certain facts when drawing conclusions. Emotional reasoners will consider their
emotions about a situation as evidence rather than objectively looking at the facts.
“I’m feeling completely overwhelmed, therefore my problems must be completely
beyond my ability to solve them,” or, “I’m angry with you; therefore, you must be in
the wrong here,” are both examples of faulty emotional reasoning. Acting on these
beliefs as fact can, understandably, contribute to even more problems to solve.

‘Should’, ‘must’ statements

I must get Grade A, I should obey my parents all the time, I must have this top brand
toy set, I should be loved by all – these are the statements which are irrational and
illogical and lead to problems. Those who rely on ‘should statements’ tend to have
rigid rules, set by themselves or others, that always need to be followed — at least
in their minds. They don’t see flexibility in different circumstances, and they put
themselves under considerable stress trying to live up to these self-imposed
expectations. If your internal dialogue involves a large number of ‘shoulds,’ you may
be under the influence of this cognitive distortion.
Labeling and Mislabeling
Those who label or mislabel will habitually place labels that are often inaccurate or
negative on themselves and others. “He’s a whiner.” “She’s lazy.” “I’m just a useless
worrier.” These labels tend to define people and contribute to a one-dimensional
view of them, paving the way for overgeneralisations to move in. Labeling cages
people into roles that don’t always apply and prevents us from seeing people
(ourselves included) as we really are.
Personalisation
When you attribute everything to your self – that you are the cause of it – it causes
anxiety and distress. Those who personalise their stressors tend to blame themselves
or others for things over which they have no control, creating stress where it need
not be. Those prone to personalisation tend to blame themselves for the actions of
others, or blame others for their own feelings.
Cognitive behaviour therapy aims at identifying our faulty/irrational thought patterns
and making them conscious. The patient is then able to recognise when he is about
to perform an undesirable behaviour, such as compulsive hand-washing, or when he
is engaging in negative thoughts that are not supported by logic or reality. The process
then calls for the patient to halt the behaviour or thought, then consciously replace it
with a desired thought or behaviour.

1.3.4 Techniques Used by CBT Specialists

Therapists use several different techniques in the course of cognitive-behavioural
therapy to help patients examine the dysfunctional thoughts and change to rational
thoughts and behaviours. These include:
i) Reality testing: The client is asked to put his thought to test in the real situation.
Thus the client tests it experimentally.
ii) Validity testing: The therapist asks the patient to defend his or her thoughts
and beliefs. If the patient cannot produce objective evidence supporting his or
her assumptions, the invalidity, or faulty nature, is exposed.
19
Cognitive Behavioural iii) Guided discovery: The therapist asks the patient a series of questions designed
Counseling
to guide the patient towards the discovery of his or her cognitive distortions.
iv) Writing in a journal: Patients keep a detailed written diary of situations that
arise in everyday life, the thoughts and emotions surrounding them, and the
behaviours that accompany them. The therapist and patient then review the
journal together to discover maladaptive thought patterns and how these thoughts
impact behaviour.
v) Homework: In order to encourage self-discovery and reinforce insights made
in therapy, the therapist may ask the patient to do homework assignments.
These may include note-taking during the session, journaling, review of an
audiotape of the patient session, or reading books or articles appropriate to
the therapy. They may also be more behaviourally focused, applying a newly
learned strategy or coping mechanism to a situation, and then recording the
results for the next therapy session.
For instance, Sheela felt bad and depressed when her friends did not take her to the
market visit. Here the therapist can help Sheela identify the basic assumption she
has here which is obviously an irrational thought pattern. Why should Sheela feel
that she is bad if her friends did not take her? Does she have all the bad qualities?
What are they? Sheela is then helped to analyse the distortions in her thinking that
she is the cause, i.e., she is bad, so her friends did not take her.

1.4 RATIONAL EMOTIVE BEHAVIOUR THERAPY

Albert Ellis is the founder of the Rational Emotive Behavioural Therapy. He talks
about the irrational beliefs which are responsible for our behavioural and emotional
problems/disturbances.
According to Ellis (1962), the eleven common irrational beliefs are:
● It is essential to be loved and approved by every significant person in one’s life.
● To be worthwhile, a person must be competent, adequate and achieving in
everything attempted.
● Some people are wicked, bad, and villainous and should be blamed or punished.
● It is terrible and disastrous whenever events do not occur as one hopes.
● Unhappiness is the result of outside events and a person has no control over
such despair.
● Something potentially dangerous or harmful should be a cause of great concern
and should always be kept in mind.
● Running away from difficulties or responsibilities is easier than facing them.
● A person must depend on others and must have someone stronger on whom to
rely.
● The past determines one’s present behaviour and thus it cannot be changed.
● A person should get upset over the problems and difficulties of others.
● There is always a right answer to every problem, and a failure to find this
answer is a disaster.
These beliefs are called irrational because these are rigid, not based on the fact. The
REBT help the clients to identify the irrational beliefs and think more rationally. This
is done by the ABCD model proposed by Ellis where
20
 Introduction to Behaviour
A refers to activating events i.e., events/situations causing the distorted Modification and Cognitive
thinking Approach in Counseling

B refers to beliefs, the evaluative beliefs – rational or irrational – which

we have about the activating event
C refers to the consequences – the emotional, behavioural and cognitive
consequences of the beliefs
D refers to disputing the beliefs on which our irrational thoughts are based

1.4.1 The Sequence in the REBT Model

First, the activating events are identified, then the consequences of this event are
identified. Events lead to consequences. However, events as such do not lead to
consequences. The consequences or our responses are based on our belief system
about the events/situations. When these beliefs are irrational, it results in problems;
hence, we need to dispute these. Let us see one example. One evening, Hari was
not doing his study and was watching TV; his mother scolded him saying he always
sees TV and does not do his studies properly. Hari felt very sad for his mother’s
scolding. Here the activating event (A) is mother’s scolding; consequence (C) is
Hari’s sadness; this sadness resulted because of Hari’s belief (B) system – that my
mother always scolds me or nobody loves me - ; this irrational belief then needs to
be disputed (D). Disputation is the most important step in the REBT therapy.
Cognitive behavioural approach is widely used for dealing with a range of disorders.
Obsessive compulsive disorders, phobias, panic disorder and post-traumatic stress
disorder are all conditions that are effectively treated by cognitive behaviour
modification. Cognitive-behavioural therapy attempts to change clients’ unhealthy
behaviour through cognitive restructuring (examining assumptions behind the thought
patterns) and through the use of behaviour therapy techniques. Cognitive-behavioural
therapy is a treatment option for a number of mental disorders, including depression,
dissociative identity disorder, eating disorders, generalised anxiety disorder,
hypochondriasis, insomnia and obsessive-compulsive disorder.

1.4.2 Potentials and Limitations of Cognitive Behavioural

Approach
Cognitive behavioural approach aims at correcting problematic underlying
assumptions, thus leading to long-term results. Thus the cause of the problem is
corrected.
The structured nature of therapy sessions ensures bringing about fruitful result/outcome.
It very much reduces the possibility that sessions will become “chat sessions” in
which not much is accomplished therapeutically.
The course of treatment is shorter than that of conventional talk therapy. This makes
the cognitive behaviour modification as a less expensive means of obtaining mental
health treatment.
The self-help element of cognitive behaviour therapy enables the clients to on their
own to maintain their own treatment even after formal therapy has ended.
Cognitive behaviour modification can be performed individually or in group therapy
sessions.
These therapies are best known for treating mild depression, anxiety, and anger
21
problems.
Cognitive Behavioural Cognitive-behavioural therapy may not be appropriate for all patients. Patients with
Counseling
significant cognitive impairments (patients with traumatic brain injury or organic brain
disease, for example) and individuals who are not willing to take an active role in the
treatment process are not usually good candidates. It may not be appropriate for
small children also who will not have the language capability to think through their
assumptions and thought patterns.

Self Assessment Questions

1) Elucidate with example the various types of cognitive distortions given by Beck.
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2) What do you mean by irrational beliefs? Write down three irrational beliefs
with example.
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3) What is the ABCD sequence in Rational Emotive behaviour therapy?
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4) What do you mean by home-work assignment in cognitive behaviour therapy?
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1.5 LET US SUM UP

This unit gives some insight into the behavioural and cognitive approach to counseling.
The behavioural approach is based on the two learning theories of classical
conditioning by Pavlov and operant conditioning by Skinner. The principles and
procedure of behavioural approach are described in detail. We also learned about
the different behavioural techniques. One of the important techniques under
behavioural counseling is systematic desensitization which aims at shaping the
behaviour of the person in a systematic manner. We also came to know about the
cognitive behavioural techniques such as cognitive behaviour therapy and rational
emotive behaviour therapy which are widely used for dealing with various problem
behaviours. The combination of cognitive therapies with behaviour modification has
22 been found to be more effective than either of these approaches alone. They have
been found to be successful in managing many maladaptive behaviours such as phobia, Introduction to Behaviour
Modification and Cognitive
depression, anxiety etc. Finally the merits and limitations of the behavioural and Approach in Counseling
cognitive approach to counseling were also discussed.

1.6 UNIT END QUESTIONS

1) Explain and contrast the behaviour modification and cognitive therapy in
counseling.
2) As part of behavioural assessment, what are the different aspects of behaviour
that we need to study? Describe with the help of an example.
3) Take a case example. Describe the procedure of systematic desensitization.
4) Give three examples of children’s behaviour in classroom learning situations
where token economy can be used.
5) Briefly explain Beck’s cognitive behaviour therapy,
6) Describe the ABCD model of Rational Emotive Behaviour therapy with an
example.
7) List out five problems found among school children and describe the behaviour
and cognitive techniques you will use for any three of them.

1.7 SUGGESTED READINGS

Ellis, A. (1970). Rational Emotive Therapy and its Application to Emotional
Education. Institute of Rational Living, New York.
Gladding, S. T. (1996). Counseling: A Comprehensive Profession (3rd Ed.). New
Jersey:Prentice Hall Inc.
Hackney, H. & Cormier, S. (2005). The Professional Counsellor: A Process
Guide to Helping (5th ed.). Boston: Allyn & Bacon.
Martin, Garry & Pear, Joseph (1996). Behaviour Modification: What it is and
How to do it, 5th edition. New Jersey: Prentice-Hall.
Miltenberger, R. G. (2004). Behaviour Modification Principles and Procedures
(3rd ed.). California: Wadsworth/Thompson.

References
Beck, A. T. (1976). Cognitive Therapy and Emotional Disorders. New York:
International Universities Press.
Berne, E. (1964). Transactional Analysis in Psychotherapy: The Classic
Handbook to its Principles. London: Souvenir Press.
Burns, David, M.D. (1992). Feeling Good: The New Mood Therapy. New York
:Avon Books.
Corey, Gerald (2009). Theory and Practice of Counseling and Psychotherapy.
Belmont, CA: Thomson Brooks/Cole.
Ellis, A. (1960). The Art and Science of Love. New York:Bantam.
Ellis, A. (1962). Reason and Emotion in Psychotherapy. New York:Lyle Stuart
press.
Meichenbaum, D. (1977). Cognitive behaviour Modification: An Integrative
Approach. New York:Plenum. 23